First you take a drink, then the drink takes a drink, then the drink takes you.
Francis Scott Key Fitzgerald
By the time Shankar Subramaniam came to see me, he’d been drinking heavily for ten years. When I asked him how he was feeling, though, his answer was, “I’m fine.”
“Dr. Siby,” Shankar’s wife said, “he is not fine. The doctor said he has end-stage liver cirrhosis. There is nothing more they could do for him.”
Shankar was told to go home and, effectively, wait for death. His skin was leathery, his eyes bloodshot and puffy. When he did speak, his breath stank of alcohol. At 102 kg, he was severely overweight and could barely move. He looked 70 years old.
What was more puzzling was his attitude. It wasn’t the usual resignation that I saw in terminally ill patients. There was an outward arrogance about him. Yet, there was a latent anger in him.
Out of the blue, he said, “My father died at 50, you know.”
“Err… yes?” I was a little confused about this piece of information.
Shankar shrugged, “Well, I’ve lived a good life.” What could make a man so angry for being alive? In all honesty, I wondered if I could truly help Shankar.
So I asked what I knew would be a simple question: “How is your sleep?”
He responded with a question. “Why is sleep so important?”
We believe that the mind is the inner instrument and the master organ that connects and coordinates all other organs. There are three main mental states: Satwa (exemplified by balance and harmony), Rajas (the stimulation for action and energy expended in any action) and Tamas (a secure base for the mind). To achieve that balance among them, we need sleep.
I then asked him, slowly, “So, will you let me try to help you?”
Without batting an eyelid, he said, “Yes, doctor.”
I took a deep breath and said, “OK. It is going to take at least a month before we see any results at all. But I can try.”
Shankar wasn’t going to undergo a detox programme because his body was already too weak to handle it. There were two parts to his treatment: First, I would introduce a diet that was easy to digest and not a burden on his liver. Second, the medicine administered was to revive his liver and slowly create a healthier digestive fire in him.
As difficult as the treatment was on Shankar, it was equally difficult for us. No sooner had he swallowed the medication, he would vomit close to 1 litre of foul-smelling yellow-green liquid. This was to be expected, seeing that he was suffering liver damage.
Nonetheless, three days after he started treatment, he said that he had regained some sense of taste. He was also able to sleep.
On Day 19, Shankar asked if he could show me what he’d written in his journal. Once I sat down next to him, he opened to one page and pointed to the only word he’d written there: Sarah.
I asked the obvious question, “Who is Sarah?”
Shankar started to speak for a good 10 minutes without interruption. This is the gist of what he said:
“When I was 23, I graduated with a law degree from the London School of Economics. I had a ready job in one of the most prestigious firms in Kuala Lumpur. But, by 28, I wanted more. So, I started my own practice. On my 30th birthday, I had enough money to buy my dream 450 SL Mercedes and I was living the dream. It’s with my clients that I first started to drink heavily. Then, my mother insisted I get married. In University, I had a girlfriend. An Irish girl called Sarah. When she became pregnant, I wanted her to have an abortion. She’s Irish. Catholic and all. She refused and our relationship ended. I never saw her again, but I still think about my child. No one in Malaysia knows this. Not even my wife. I miss my child. Dr. Siby. And she took that child away from me.”
I knew that this was a breakthrough for him. I left him to rest and decided to wait at least a week before sharing my thoughts on the matter with him.
When it was time, I said: “There are two things. Firstly, in your story, you told me that Sarah wanted the child and you did not. In fact, you’re the one who asked her to have an abortion. Then you say she took the child away from you. This is not fair.”
I could see that he was becoming agitated from what I was saying. I put my hand on his and added, “I’m not accusing you of doing something wrong. I’m saying that it’s not fair on you. You need to be honest with yourself. Only when you have accepted the truth can we move forward.”
After a long while, he looked up at me and asked, “And the second piece of advice?”
I took a deep breath before I said, “We can’t change the past. We can only live in the present moment. Right now, you have a wife and family who love you. They want you to live.”
“So,” he said to me, “what do I do now?”
That’s when I gave him a big smile and told him, “I can only help you heal physically right now. What you choose to do after this is entirely up to you. OK?”
“OK, Dr. Siby. I have a lot of thinking to do.”
At the end of the 35 days of treatment, he had lost 12 kg. He could walk with some ease and the swelling in his legs had lessened. He was discharged and continued treatment at home.
Three months later, when I saw him, Shankar had lost another 10 kg. He showed me the results of his blood test. I was very pleased to note that all his readings were now normal.
Shankar also brought along his journal. It was full of words, drawings and ideas that all meant something to him. But, there was hardly any mention of his father. This made me wonder if there was some sort of tragedy or trauma in Shankar’s early life that he had buried deep in his psyche. However, until Shankar was willing to acknowledge that there was a problem, there was no way for me to help him find a solution. There was nothing more I could do for him and I wished him well. I asked him to return to the Ayur Centre for a follow-up treatment in about three months. I have not seen him since.
(29 August 2017)
This story is an excerpt from Knowledge of Life: Tales of an Ayurvedic Practitioner (ISBN 978-967-415-4004) by Vaidya C.D. Siby and Aneeta Sundararaj. It is an enlightening book published by MPH Publishing that dispels the myths surrounding this ancient medical system.